Chapter 4: Chamomile

Somehow, I managed over the span of three years, to get degree #4 [the tamest form of them all] of achalasia, also known in hospital corridor lingo as "mega-esophagus". When I receive the verdict, the doctor disappeared into the hospital's interior for at least forty minutes. He was gleaming when he came back. He said, "everyone at the hospital cannot believe it, this is something that is so rare, and even when it occurs, it is rarely caught... you my dear son are the popular guy around." Oh the joy.

We leave his office understanding the following:

- Achalasia is a rare disease. When it arises in its "pure form," meaning that it is not caused by an external factor [enter tropical mosquitoes!] it has no known cause and no known cure. Woohoo!

- Achalasia, in this form, happens to 0.5 among 300,000 people. Half of me, or better yet, one full me got this among 600,000 people. That is just great. What else?

- It starts with a subtle closure of the lower part of the esophagus. The affected start experiencing choking [check!], difficulty swallowing liquids [check!] and solids [check!] and quite often painstaking pains in the stomach. Burning sensations [preaching to the choir] across the digestive system and most often lead to mal-nutrition.

- When un-treated for a long time, affected Achalasians develop a second stomach on the esophagus. Because of now swallowing food properly, one stores food in the upper digestive system and so the esophagus expands to the extent that it looses its function as a passage way. It no longer performs its contracting sphincter function and becomes a dead muscle.

- There are a few options to treating these. The old way consisted of inflating a balloon up the oesophagus and expanding the lower section so the passage function is enabled. The solution is temporary, it creates damage and it has to be reverted, done again every six months, and eventually will require surgery. The new option consists of surgery. This part was a bit unclear in Ecuador. No cases of Achalasia had been registered across the main hospitals. And this meant no real expertise was around.

We start consulting with doctors left and right. I did not have time for it. Most of my research was done by my caretakers. We start meeting specialists in gastro surgery. most of whom had become popular doctors as the obesity surgeries and the gastric bypass became popular among the high class in Ecuador. In quick fashion, we short-list two doctors. Their costs were similar. This factor was important as I forewent my insurance since leaving New York and was uncovered. In any event, my parents are not allowing anything but the best and these were the best. We are told be each of them, that they were the specialists on the theme. Both had performed hundreds of reflux fundouplication procedures, an operation a Dutch had devised to fix reflux problems, and then they described the actual needed procedure, a Dhor-something surgery, was something they had not per-se done but were in full confidence to do it.

The process is outlined. We are told that this would be a simple surgery overall. I would be admitted early morning on a Monday, and then admitted to the surgery room that day, be surgerized, and then be interned for two days. A liquid diet should follow for four days. After that, a semi-liquid only diet for 10 days. And then the process would follow with a semi-solid diet for three weeks. I would be able to work in a week's time. I would not be able to drive for seven days following the operation. But after that, it should all go swimingly.

My parents are concerned. My grandfather opens old encyclopaedias. He learns about the described procedures but also learns further about the disease. I am asked to take ownership and do so superficially. I start learning that the expertise world-wide is quite limited. This seemed in line with the doctors' verdict. I also learn that in Brazil, this is a frequent disease. Not achalasia itself, but the mega-esophagus reference. Apparently there is a lovely tiny mosquito, living and frolicking in tropical climates, called Shagas. When this beast of a fly bits you, you might as well relinquish all territory and expire. Flews, dissiness, even death occur. All of this with the major luck of also receiving the dormant, lazy, uncooperative oesophagus. We learn this but somehow remain convinced the treatment I would receive is fair and positive. In my rushed, let's-just-deal-with-this, mode, we decide to schedule a surgery for Monday, December 8th. A few days after the Fiestas de Quito. The crazy partying that my city ensues around bull-fighting. With the notice ahead. we proceed.

But life turns. My "madrina," godmother, and grandmother, falls sick. A woman whose legacy had been the prime source of inspiration for our family, who has combated the inability to listen to the world, falls sick. We think twice. The timing does not suit. We post-pone the surgery for the new year. I remain. She, however, one day, greets the day unconscious. What followed was unthinkable. Days of details I shant relay ensue. And in the gleaming sunny morning of December 23rd, with her entire family around her, at 8:15 in the morning, with all of us, husband, children, grandchildren, around her, covered in tears, sobbing, gives us the honor of her final breathe. My mother shant revover. My grandfather shant recover. Me shant recover. No one in that room shant. I thought this. We shant. We shant. We shant.

I did not any of us to forget. To give way to anything other than praising her memory. Instant recalls come back. My green eyes, in ages two to eight, sensitive as hell, and running around the fields in our farm hose, felt prey to the sun and allergies. And there she is wrapping my eyes, forehead, with medicine water. Chamomile. In scented handkerchiefs that seemed brought by her from ancient queens. To cure her grandson, her godson. Twirls in hospital rooms. We smiled inside. Her example was one of the deepest equanimity, of absolute love, and compassion. She had grown in privilege and then endured a life that quickly turned as life ensued and fortunes changed. Through it all, wisdom. And love. Her pinches to correct our table manners, always followed by a grin from the heart. Her support, intergallactic and present, while away in the world, or by her side. She was murmurs of flowers. I think we still live them. Hear them loudly. That damn December 23rd presenting us to a departure and a void that was a defining point and a turning event. Chamomile. Chamomile.

We all retreated. To a Christmas that did not have her present. But had her omnipresent.

We all retreated. To a beach house that had overflowing water. Currents. Infinite water currents.

We all retreated. To a place of pride. Of deeper inner pride. Knowing. She is. In us.

Her chamomile bathes my throat. My mega throat. Aching. For the presence.